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May 01, 2012 at 11:17 AM
Elderly people, people with disabilities, and representatives of people in those categories are getting excited about a chance to help shape the new federal Community First Choice (CFC) community-based long-term care (LTC) program.
Officials at the Centers for Medicare & Medicaid Services (CMS) devoted much of the preamble to the final rule for the CFC program explaining who should get seats on new state “development and implementation councils.”
The drafters of the Patient Protection and Affordable Care Act of 2010 (PPACA) added Section 2401 – the CFC program provision — and other provisions to PPACA in an effort to increase the chances that people who need long-term care (LTC) will be able to stay in their homes rather than having to enter nursing homes.
State government agencies run state Medicaid programs using a combination of state and federal money. CMS, an arm of the U.S. Department of Health and Human Services (HHS), influences the state Medicaid programs by tying access to federal aid to success at meeting federal program requirements.
The CFC program is supposed to expand Medicaid long-term support programs by providing a 6-percentage-point increase in federal Medicaid matching funds to a state that provides community-based attendant services and supports to beneficiaries who would otherwise be confined to a nursing home, CMS officials say.
A state is supposed to consult with its CFC development and implementation council when it develops or updates its CFC plan.
The CFC program law requires that each state council “include a majority of members with disabilities, elderly individuals and their representatives,” officials say in the preamble to the CFC final rule.
Many states have already been using the rules spelled out in draft regulations to start the process of organizing the councils.
Commenters have asked the CMS officials writing the final rule to include seats for caregivers on the council, ensure that some seats on the council go to people with the most severe disabilities, and take steps to emphasize how much authority the CFC development councils ought to have.
CMS officials have declined to elaborate much on the language in PPACA Section 2401. In response to a suggestion that CMS require that the CFC development councils include care providers, for example, officials say, “We disagree.”
“The statute only directs that the majority of the council must consist of elderly or disabled individuals, and their representatives,” officials say. “We do not believe it is appropriate to require other representation.”
